can anyone help with this supply/demand Q please?

[alabasterangel]

Hoping someone may be able to clarify for me - mushy brain at the moment and I'm struggling to understand.

I'm BFing my 5 week old DS and am running into problems. Bit protracted to start to explain but the long and short of it is that I'm not sure at all that I am currently producing enough milk for him. Why? Well, he starts fussing and fretting at the boob after about 10 mins, I swap to the other side and he will do the same after another 10 mins. If I unlatch him before this time I can see milk in his mouth and on the nipple, and also hear him swallowing. After this time it's "dry" and the swallowing sound/glug has pretty much stopped (although he's sucking, obviously). He's feeding every 3 hours max (sometimes 2, although now goes 4 in the night). When he has longer stretches I've started to stick in a pumping session too to try and boost my supply up, and we use that EBM towards a bedtime bottle which DH gives so I can go to bed earlier.

I know pumping doesn't give a good indication (electric pump) but I am only getting 1oz each side, even at premium times (5am this morning for example). 2 weeks ago I was getting 2oz each side (still not great, I know).

I used to feel a big let down reflex and be soaked in milk (just thinking about feeding used to start it!) I still get the sensation, but not the leaking. I also used to wake in the night during the longer stretches without feeding and have leaked loads, but that has stopped too. He used to feed for 20 minutes either side and there would still be milk left, but now it feels like there is nothing left and he's getting really frustrated & hungry. At the end of both sides he's desperate for more food, and I'm topping him up with formula as a measure to stop him screaming and I really don't want to go down this slippery slope but I can't make any more than I am now (i.e. either pumping or feeding all day no more than 2 hours apart!!!)

Basically, I do understand about supply/demand (the more you put the baby to the boob and he empties it, the more milk will be produced) but is this referring to frequency rather than quantity?? What I feel I need to try and do it produce more milk for that one feed sitting, rather than more feeds in the day as he's not happy with that - he has the lot and wants more and won't wait till I'm full again. How do you increase the amount in the breast - does feeding more frequently (as I am at the moment, and with the interim pumping as well) trigger "more" quantity wise as well?

I'm rambling I know..... but just wondered if anyone could explain?

Thanks!

The more you feed (or pump) the more you will produce. You never actually run dry btw.

The problem with topping up with formula unfortunately, rather than just swapping back to the first side after he's had both say, is that this may make him go longer between feeds than he would naturally. Your boobs won't be prompted to increase milk production and you're left playing catch up. It can be a vicious circle of not feeling he's satisfied/top up/supply doesn't increase/more top ups/supply decreases, and eventually full ff.

Babies will periodically want to feed more frequently and fuss and the breast and this prompts your body to increase your supply, but obviously there will be a few days where he might not seem to be getting enough and it's tempting to go for formula. This won't help longer term though.

It's so hard to judge. I had a crazy oversupply. Honestly it caused me so many problems, but there were times when ds would be fussing and crying at the breast, didn't seem "satisfied" and once my grandmother actually said to me "that baby's obviously getting nothing from there". Despite the fact that I was soaked from a strong letdown .

How is his weight gain? Heavy nappies?

You are absolutely right to think that the pumping is a red herring. I have never been able to get more than a couple of oz at a time, despite BFing DS1 for 2 years and I am the same now with DS2.

You are doing the right thing by swapping him to the second side once he starts to fuss, but then I would recommend swapping him back to the first side again - and so on. When I'm feeding through a growth spurt (which it does sound as if you might be) then I just keep swapping back and forth. You will get a letdown each time which will release more milk and also be sending all the right signals to your body to produce more milk.
The breast is never empty, so there is no need to wait for them to 'fill up'. And yes, feeding more frequently is the main trigger - which is why switch feeding (going from one side to the other and back again and so on) is the best way to increase supply.

Anyway, sorry I didn't answer your question. You're making milk as you feed so there's no reason you can't put him back to the first side again if you don't feel he's had enough from 2 breasts. This will stimulate your supply and you will eventually make more milk.

And I agree that topping up with formula is counterproductive because it stops the relationship between what the baby wants and what your body is told to produce.
I recommend looking at the www.kellymom.com website, it has really good info on all this stuff.

You never run dry, but the flow will slow down and impatient babies may get fussy then.

There is a typical growth spurt around 5-6 weeks, so it's probably that. Don't top-up, don't use formula and just offer the breast as often as possible. Expect some fussing at the start of growth spurts, totally normal. You have to just go with it.

And pumping is no indication of supply, ever. If I'm not expressing regularly, I only get 15ml out in one session and I've had loads of practice at expressing. My DD is 7mo and was EBF until we started BLW. If I'm expresing regulalry, I get up to 250ml in a session.

How's baby's weight

You may need RL support.Do you have a support group OR HV who can help you make sense of what's going on.

Thanks all...

Baby is packing on weight (7lb birth, 10lb 5 weeks later) loads of wet nappies.... yellow poo every single feed, filling out beautifully (cheeks like a fat hamster!) Yeah, I know.... hardly a worry!! Just a worry that it feels (and looked) like things are slowing down and I thought once your milk slows, you're on a road to it drying up completely?

Loads of RL support - have been told that latch is now good (following problems with cracked nipples - ouch) but all HV will now say is that I must be doing something right as he's gaining weight as he should. My illogical mummy-mush brain is telling me he's doing this from the tiny amount of formula (which is TINY - on top-ups we've offered 4oz bottles and he barely takes 1oz then gives up anyway, so I do wonder if comfort and plain gutsy greed is just the cause of his complaints?!)

Will keep switching sides and feeding often then I guess (so hard with a toddler as well!) - just feels so weird to think he'll keep getting more even though we both (ds and me!) seem to be thinking/acting like there is nothing there!! I had heard the "boobs are like rivers, nor buckets" thing (as in they never empty) but they must certainly slow down in flow & quantity as he is super-frustrated when he's not getting all he wants.

Never thought I'd be so gutted at the prospect of it not working out (DD was bottle fed, I wouldn't entertain BFing) but now I've done it, I can't bear the thought of stopping.....

Wow! You're doing a great job growing that baby. And it's all you, you know that deep down really.

Have a look on Kellymom & google for "switch feeding" and breast compressions. To be honest, I don't think there's anything wrong, he's just doing what nature needs him to do to boost your supply as he's growing so well, but it might make you feel more confident if you do some reading around it.

Sounds like you're doing perfectly!!

I believe it takes about 6 weeks to get breast feeding established and this includes your body getting used to how much milk it needs to produce. I was really engorged with DD1 for quite a while and then it just calmed down and I was worried I wasn't producing enough, but I fed her for 17 months and she always followed the 50th centile so obviously everything was fine.

Well done!!

Try leaning forwards as the feed goes on and using breast compressions - both can increase the flow for impatient babies!

Formula top-ups are the biggest risk for making your milk supply slow. When you hit a growth spurt, the temptation is to top up with formula, but when the growth spurt ends what usually happens in that situation is that the formula remains, so your supply drops to match the lower requirements. Do that over a few growth spurts and you'll end up introducing more formula and causing your supply to drop.

But if you don't have a - actually pretty rare - medical complication that affects milk production, then you can always get your milk supply back. It's just a lot more work than if you keep EBF in the first place.

one more q.... how comes i don't seem to have that "full boob" feeling anymore? it used to feel awful (full, heavy, dolly parton!) if he'd not fed for 3-4 hours, but not any more?

one handed typing, sorry!

It just eases as your supply adjusts to what is required. Thankfully! By 4 months, your supply will be almost entirely demand driven, whereas in the early days it is largely hormone driven (hence why your milk would come in even if you weren't feeding LO at all).

Wot japhrimel said. You'd probably find that if you went a while past his normal feed time then you'd get uncomfortable, but thankfully your body gets clever at knowing how much to make at one time so you don't get engorged.